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As I See It: Bending the Willow, as Opposed to Toppling the Oak

My time as the CEO for New Wave Home Care has been delineated by many lessons, but of all the important things I’ve learned, the power of peaceful negotiation has been perhaps the most important. Rather than coming on strong, demanding adherence to every edict, I’ve found that seniors, like all of us, respond best to compromise…and creative, win-win solutions, rather than sweeping edicts.

I’m thinking of a client we called “The Major”, an impressive older gentleman with a long and storied career as a military commander. Like so many grizzled leaders, he enjoyed his end of the day respite in his lounge chair, whiskey swirling in his glass, ice assembled in a perfect, end of the day formation. He had seen some things, the Major, and his evening ritual had not changed over the decades.

When his young doctor voiced concern that given his patient’s age (which was well into the late 90s), alcohol was no longer recommended, I of course understood. And yet, I hated to deprive this World War 2 veteran and courageous hero his daily and much savored reward for a job and day well done.

Understandably, given his age and station, negotiating with the Major would be also challenge. His severe cognitive problems, exacerbated by a lifetime of leadership and treatment with deference by others, would put his caregiver in a tough spot if she demanded abstinence. After all, he also insisted on picking out the whiskey himself when she took him shopping.

What would we do? I certainly didn’t relish the idea of telling a man who had risked his life and protected those of others time and again what he could and couldn’t consume. He was cranky, too.

“We have to get creative,” I told his caregiver. “Brew some tea.”

“Why tea? He wants whiskey!” she said.

“Give him a tiny bit of whiskey when you pour it, but add the tea to the bottle for color and he won’t notice it’s been watered down.”

This worked beautifully. Every time Major looked at his whiskey bottle, it was always almost full. He had his drink every day, holding court by the fireside as if nothing had changed. The fact his bottle’s alcohol level was almost untraceable was moot. His ritual and his dignity remained intact.

Mary Anne was another client who required a bending of the willow, rather than a toppling of the oak, so to speak. This beautiful woman, well into her 80s, loved to shop. Tireless in her pursuit of the perfect outfit or accessory, she could shop till she dropped… and still not be done. She had more shoes than she could ever wear, more dresses than would be needed by even the busiest socialite. She had enough perfume to fill a bathtub.

Mary Anne had been a model in her earlier life and a successful one, too. She has done very well, but even with a well financed retirement, her budget could not afford endless indulgences forever.

Sadly, she had suffered a stroke in the past, resulting in a marked cognitive decline. Reasoning rationally with Mary Anne was out of the question. It would upset her, and only remind her of the sad and marked difference between her former circumstances as a gorgeous, sought after beauty and her current reality as a still lovely, but older “former” model. She cried bitterly when her doting family tried to explain she could no longer afford to purchase whatever she wanted on a daily basis.

“But I want a new dress!” she cried. “I need new shoes!”

No one had the heart to see her in such distress, and yet, she would be soon penniless if her spending continued. We sat down for a meeting. I had a solution.

Every day, as Mary Anne wanted, she would shop with her caregiver. When it came time to purchase the items, the caregiver would “handle the payment” and arrange for the items she had so carefully selected to be “sent along to the home later.” Of course, given her present cognitive limitations, she would never notice that she hadn’t indeed purchased anything, nor later would she remember when nothing was delivered.

She had the joy of choosing among beautiful clothes, shoes, and jewelry, and yet, would not ever remove them from the store-or be obligated to pay for them.

A call ahead to the shops involved and generous reviews on Yelp paved the way for this beautiful senior to indulge her hobby, and the retailers were pleased to help. And her retirement savings remained intact.

Finally, I recall Lucy, a client who was notable for two things, aside from her sweet demeanor. First, she had always lived in the same home on a leafy street in Pasadena from birth until the present day. Once she had lived there with her beloved mother, who had passed away several decades earlier, until today, when Lucy lived there with a caregiver. The second fact about Lucy that everyone who came into contact with her needed to know…was that Lucy was always terrified she was not yet home.

“I need to go. My mother’s phone isn’t working and I didn’t tell her I was staying out late,” she would anxiously remind her caregiver. At 89, Lucy was like a scared teenager, worried she’d be grounded for staying out too late.

Rather than disagree with her, I advised the caregiver simply to offer Lucy a ride when she was worried.

“Well, let’s go home now, then. I’ll give you a ride.” I told her caregiver, Martha, to say.

And so they would go. Lucy and Martha would get in Martha’s car, and drive around for a few blocks. They would return, and Lucy would feel much better, her mind, for awhile, anyway, relieved of this heavy and mysterious burden.

I often reflect on our day to day experiences providing care for clients with a cognitive capacity decline. Everyone is different, and it would be a mistake to generalize an approach. However, I am frequently reminded of how fruitless it is to adopt an adversarial approach with others, especially our clients. Redirection, compromise, or simply even agreeing with the cognitively impaired client is always more successful. As a person and a parent too, I am now far less demanding in my approach to others. And the strange thing? I find far more success in getting what I want by adopting that attitude of compromise. While there might be tea in my whiskey, so to speak, it goes down well all the same.